High-Sensitivity C-Reactive Protein: Retrospective Study of Potential Blood Biomarker of Inflammation in Acute Mild Traumatic Brain Injury

Author Type(s)


Document Type


Publication Date

May 2019

Journal Title

The Journal of Head Trauma Rehabilitation


OBJECTIVE: A panel of biomarkers is needed to definitively diagnose mild traumatic brain injury (mTBI). There is a clear role for the inclusion of an inflammatory biomarker. This study looked to find a relationship between high sensitivity C-reactive protein (hsCRP), an inflammatory biomarker, and mTBI. SETTING: Neurology department of high-volume tertiary orthopedic hospital. PARTICIPANTS: Individuals diagnosed with mTBI (n = 311, age 21 +/- 12 years, 53% female). DESIGN: Retrospective cohort study. MAIN MEASURES: hsCRP levels; postconcussive symptoms; demographics. RESULTS: Continuous hsCRP levels were transformed into quartiles, as defined by less than 0.200 mg/L for quartile 1 (Q1); 0.200 to 0.415 mg/L for quartile 2 (Q2); 0.415 to 1.100 mg/L for quartile 3 (Q3); and greater than 1.100 mg/L for quartile 4 (Q4). Mean hsCRP was elevated in the cohort of individuals who presented within 1 week of injury and was found to significantly decrease between the first visit and 4 weeks postinjury (P = .016). Initial hsCRP level was positively correlated with age (r = 0.163, P = .004), and age significantly increased between quartiles (P = .013). Patients with increased age (odds ratio: 3.48) and those who endorsed headache (odds ratio: 3.48) or fatigue (odds ratio: 2.16) were significantly associated with increased risk of having an hsCRP level in Q4. CONCLUSION: hsCRP may be a viable addition to acute and longitudinal biomarker panels for diagnosis and prognosis of mTBI.